PROJECTSUMMARY emochaMobileHealth,IncandJohnsHopkinsinvestigatorshavedevelopedauser-friendly, HIPAAcompliantapplicationforasynchronousvideodirectlyobservedtherapy(DOT)?miDOT. ThemiDOTplatformconsistsofapatient-facingmobileapplicationwherepatientscanrecord videosofthemselvestakingmedicationattheirconvenienceandaprovider-facingwebportal thatallowsproviderstomonitoradherenceandprogress,visualizedata,generatereports,view sideeffectsreports,andautomaticallysendSMSmedicationreminders.Theplatform representsapatient-centeredstrategyforimprovingadherencesupportandovercomescost andlogisticalbarrierstotraditionalDOTwhilemaintainingpatientautonomyandrespect. OurSBIRPhaseIeffortssuccessfullydemonstrated:1)technologicalfeasibilityofusingmiDOT forTBtreatmentmonitoring2)miDOTisacceptableandpreferredbypatientsandprovidersfor TBtreatmentand3)miDOTiseffectiveatensuringhighlevelsofadherenceandtreatment completion.However,severalkeyknowledgedeficitsexist.First,ourPhaseIeffortsfocusedon patientswithpriordemonstrationofgoodadherenceinonestate.Itisnowimperativeto demonstratethatmiDOTwouldbeusedandeffectiveinabroaderpatientpopulation.Second, currentvideo-DOTeffortshavefocusedonactiveTBpatients;?however,publichealthauthorities havealsoprioritizedtreatmentfortheestimated13millionpeopleintheUSlivingwithlatentTB infection(LTBI).AshortcourseregimenforLTBIisrecommendedtopreventprogressionto activeTB,andconsistsof3monthsofweeklyisoniazid(INH)andrifapentine?or3HP- administeredunderDOT;?however,uptakehasbeenlimitedduetothisDOTrequirement,which isnotlogisticallyfeasiblewithsuchhighpatientvolumes.Alternativeself-administeredLTBI treatmentscanbeprescribed,butarelengthy(4-9months)andhavepoorcompletionrates. Finally,thereisaneedtodefinebestpracticesformiDOTintegrationandadoptionintocurrent TBprograms.OurSBIRPhaseIIgoalistoguideprogrammaticscale-upthrough implementationresearchwhilebuildingthenecessarytechnicalinfrastructuretoallowthe systemscalecommerciallytomeettheneedsoflargerpatientpopulations.